质子泵抑制剂和氯吡格雷联用与支架内再狭窄关系的回顾性研究

Effects of proton pump inhibitors on in-stent restenosis in patients receiving clopidogrel:a retrospective analysis

目的:评估接受经皮冠状动脉介入治疗术后患者,氯吡格雷联合质子泵抑制剂治疗是否会增加支架内再狭窄的风险。方法:根据服用氯吡格雷抗血小板治疗的同时是否使用质子泵抑制剂,分为氯吡格雷治疗组(n=250)和氯吡格雷+质子泵抑制剂治疗组(n=189),比较分析两组患者支架内再狭窄发生率。结果:平均随访(13±5.9)月观察发现,经皮冠状动脉介入治疗术后氯吡格雷加用质子泵抑制剂治疗组患者,支架内再狭窄发生率明显高于未使用质子泵抑制剂治疗组患者(19.6%vs 8.0%),两者比较差异具有统计学意义,P<0.001。结论:经皮冠状动脉介入治疗术后患者,使用氯吡格雷治疗的同时联用质子泵抑制剂增加了支架内再狭窄的发生率,质子泵抑制剂的使用可能会影响经皮冠状动脉介入治疗术后患者使用氯吡格雷抗血小板治疗的临床获益。

Objective: To determine the effect of proton pump inhibitor(PPI) on in-stent restenosis(ISR) in patients receiving clopidogrel therapy. Methods: Total 439 patients underwent percutaneous coronary intervention(PCI) were enrolled in the study,including 250 post-PCI patients discharged on clopidogrel alone and 189 patients discharged on clopidogrel with PPI.The in-stent restenosis(ISR) ratio of the patients in these two groups were observed. Results: During a mean follow-up period of(13±5.9) months,the post-PCI patients discharged on concomitant clopidogrel-PPI therapy had higher risk of ISR than those discharged on clopidogrel alone(19.6% vs 8%,P<0.001). Conclusion: Concomitant use of clopidogrel and PPI after hospital discharge would increase the risk of ISR for post-PCI patients.